Asthma in Children: Symptoms and Risk Factors

Asthma is the leading cause of chronic illness in children. It affects more than one of every 10 children in the U.S., and, for unknown reasons, it is steadily increasing. It can begin at any age, but most children have their first symptoms by age 5.

What Makes a Child More Likely to Develop Asthma?

There are many risk factors for developing childhood asthma. These include:

  • Presence of allergies -- food or environmental
  • Family history of asthma or allergies
  • Frequent respiratory infections
  • Low birth weight
  • Obesity
  • Exposure to tobacco smoke before or after birth
  • Presence of eczema, a chronic skin condition
  • Being male
  • Being black
  • Being raised in a low-income environment


Why Are More Children Getting Asthma?

No one really knows why more children are developing asthma. Some experts suggest that children are being exposed to more allergens such as dust, air pollution, and second-hand smoke. These are factors that can all trigger asthma. Others suspect that children are not exposed to enough childhood illnesses to build up their immune systems. It appears that a disorder of the immune system in which the body fails to make enough protective antibodies may play a role in causing asthma.

Still others suggest that decreasing rates of breastfeeding have prevented important substances of the immune system from being passed on to babies, although rates, as of 2013, have begun to climb, according to the CDC.


How Can I Tell If My Child Has Asthma?

Signs and symptoms to look for include:

  • Frequent coughing spells, which may occur during play, at night, or while laughing; it is important to know that cough may be the only symptom present.
  • Less energy during play (especially when compared to peers) with the need for frequent rest periods to catch breath
  • Rapid breathing
  • Complaint of chest tightness or chest "hurting"
  • Whistling sound (wheezing) when breathing out
  • See-saw motions (retractions) in the chest from labored breathing
  • Shortness of breath, loss of breath
  • Tightened neck and chest muscles
  • Feelings of weakness or tiredness
  • Dark circles under the eyes
  • Frequent headaches
  • Loss of appetite

Keep in mind that not all children have the same asthma symptoms, and these symptoms can vary from one asthma episode to the next in the same child. Also note that not all wheezing or coughing is caused by asthma.

In kids under age 5, the most common cause or trigger of asthma-like symptoms is upper respiratory viral infections such as the common cold.

If your child has problems breathing, take him or her to the doctor immediately for an evaluation.

How Is Asthma Diagnosed In Children?

Asthma is often difficult to diagnose in infants. However, in older children the disease can often be diagnosed based on your child's medical history, symptoms, and physical exam.

  • Medical history and symptom description. Your child's doctor will be interested in any history of breathing problems you or your child may have had, as well as a family history of asthma, allergies, a skin condition called eczema, or other lung diseases. It is important that you describe your child's symptoms -- cough, wheezing, shortness of breath, chest pain or tightness -- in detail, including when and how often these symptoms have been occurring.
  • Physical exam. During the physical examination, the doctor will listen to your child's heart and lungs.
  • Tests. Many children will also have a pulmonary function tests. Also called lung function tests, these tests measure the amount of air in the lungs and how fast it can be exhaled. The results help the doctor determine how severe the asthma is. Generally, children younger than age 5 are unable to perform pulmonary function tests. Thus doctors rely heavily on history, symptoms, examination, and response to treatment in making the diagnosis.

Other tests may also be ordered to help identify particular asthma triggers. These tests may include allergy skin testing, blood tests and X-rays to determine if sinus infections, or gastroesophageal reflux disease (a gastrointestinal condition that causes reflux of acid stomach contents into the esophagus or even into the lungs) is complicating asthma.

WebMD Medical Reference Reviewed by Renee A. Alli, MD on April 17, 2018



National Heart Lung and Blood Institute: "Guidelines for the Diagnosis and Management of Asthma (EPR-3)."

American Lung Association: "Asthma & Children Fact Sheet."

KidsHealth: "Asthma Basics." "Diagnosing Asthma."

American Thoracic Society: "Pulmonary Function Testing in Children."



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